胃肠道肿瘤术后胃肠功能障碍影响因素的Meta分析  

Influencing factors of postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors:A Meta-analysis

作　　者：张梦 张华倩 马晓雯 汤苏娜 陈淑芳[2] 霍蕊[3] 朱宁宁[1] ZHANG Meng;ZHANG Huaqian;MA Xiaowen;TANG Suna;CHEN Shufang;HUO Rui;ZHU Ningning(School of Nursing,Bengbu Medical College,Bengbu 233000,China;Department of Orthopedics,The Second Affiliated Hospital of Bengbu Medical College,Bengbu 233002,China;Department of Gastrointestinal Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院护理学院,安徽蚌埠233000 [2]蚌埠医学院第二附属医院骨科,安徽蚌埠233002 [3]蚌埠医学院第一附属医院胃肠外科,安徽蚌埠233000

出　　处：《中国肿瘤外科杂志》2023年第4期396-403,共8页Chinese Journal of Surgical Oncology

基　　金：安徽高校人文社会科学研究项目(SK2020A0365)。

摘　　要：目的探讨胃肠道肿瘤术后胃肠功能障碍的危险因素,为胃肠道肿瘤患者术后胃肠功能障碍的预防及干预提供依据。方法系统检索PubMed、Web of Science、Cochrane library、Embase、中国知网、中国生物医学数据库、万方数据库、维普中文期刊数据库自建库至2022年10月1日的相关文献,由2名研究者独立筛选文献和提取资料并评价纳入研究的偏倚风险后采用Review Manager 5.3软件进行Meta分析。结果共纳入23篇文献,文献质量整体在中等及以上,总样本量为43878。Meta分析结果显示,性别男(OR=1.58,95%CI:1.25~2.01,P=0.002),年龄≥60岁(OR=2.60,95%CI:1.76~2.87,P<0.001),体质指数≥25.3 kg/m^(2)(OR=1.06,95%CI:1.00~1.12,P=0.040),吸烟史(OR=1.89,95%CI:1.31~2.73,P<0.001),慢性阻塞性肺疾病(OR=1.49,95%CI:1.22~1.83,P<0.001),肠造口术(OR=1.47,95%CI:1.26~1.70,P<0.001),腹部手术史(OR=2.90,95%CI:1.67~5.03,P<0.001),手术部位(OR=1.92,95%CI:1.40~2.62,P<0.001),手术方式(OR=1.68,95%CI:1.08~2.62,P=0.020),手术时长(OR=2.65,95%CI:1.92~3.67,P<0.001),腹腔粘连等级(OR=2.52,95%CI:1.90~3.56,P<0.001),术后阿片类用药史(OR=5.35,95%CI:3.29~8.71,P<0.001)、肿瘤TNM分期(OR=2.58,95%CI:1.84~3.62,P<0.001),术后输血(OR=2.92,95%CI:0.88~9.73,P=0.010)是胃肠道肿瘤患者术后胃肠功能障碍的危险因素。结论影响胃肠道患者手术后胃肠功能障碍的因素较多,临床医护人员要及早识别相关危险因素,并在个性化评估的基础上实施针对性的干预措施,以改善患者临床预后。Objective To explore the risk factors for postoperative gastrointestinal dysfunction in gastrointestinal tumor patients,and to provide evidence for the prevention and intervention of postoperative gastrointestinal dysfunction in gastrointestinal tumor patients.Methods The relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,Wanfang Database,and the self-established database of Chinese Science and Technology Journal Database were systematically searched up to October 1,2022.Review Manager 5.3 software was used for Meta-analysis after two researchers independently screened the literature,extracted data,and evaluated the risk of bias in the included studies.Results A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was 43878.The results of meta-analysis showed that Gender(OR=1.58,95%CI:1.25~2.01,P=0.002),Age≥60(OR=2.60,95%CI:1.76~2.87,P<0.001),Body mass index≥25.3 kg/m^(2)(OR=1.06,95%CI:1.00~1.12,P=0.040),Smoking History(OR=1.89,95%CI:1.31~2.73),P<0.001),Chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22~1.83,P<0.001),Enterostomy(OR=1.47,95%CI:1.26~1.70,P<0.001),Abdominal surgery history(OR=2.90,95%CI:1.67~5.03,P<0.001),Surgical site(OR=1.92,95%CI:1.40~2.62,P<0.001),Surgical method(OR=1.68,95%CI:1.08~2.62,P=0.020),Surgical duration(OR=2.65,95%CI:1.92~3.67,P<0.001),Abdominal cavity adhesion level(OR=2.52,95%CI:1.90~3.56,P<0.001),Postoperative opioid history(OR=5.35,95%CI:3.29~8.71,P<0.001),TNM stage of tumor(OR=2.58,95%CI:1.84~3.62,P<0.001),and postoperative blood transfusion(OR=2.92,95%CI:0.88~9.73,P=0.010)are risk factors for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.Conclusions There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery.Clinical healthcare personnel should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the

关 键 词：胃肠道肿瘤手术 术后胃肠功能障碍 肠麻痹 危险因素 META分析 

分 类 号：R735[医药卫生—肿瘤]